Empirically Evaluated Suicide Prevention Program Approaches for Older Adults: A Systematic Review

Abstract Suicide is a serious public health concern, particularly for individuals in later life. Studies suggest that greater attention to suicide prevention programs for older adults is needed as well as continued research related to interventions with older adults at risk of attempting suicide. A systematic review of the literature on suicide prevention treatment and effectiveness is fundamental to assessing existing services and developing new programs and practice standards. This systematic review of the literature extends an earlier and well-cited systematic review (1966-2009) by examining articles published between 2009 and 2021 with a focus on what types of empirically evaluated suicide prevention programs effectively prevent and reduce suicidality in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to gather the appropriate extant research and improve reporting accuracy. A three-stage review guided the selection of the articles. At stage one, titles were screened, which excluded 284 articles based on the inclusion criteria. Second, after a full review of each abstract, a final 14 articles remained for full-text review. Lastly, three independent researchers reviewed each of the full-text articles, and six articles were excluded. The final sample includes eight articles (N=8). The articles were categorized into three types of programs: 1) primary and home health care, 2) community-based outreach, and 3) counseling. Following a description of the articles, the authors assessed each study using the GRADE rating system. Findings underscore the critical need for evidence-based suicide prevention programs for older adults. Implications for future research are offered.


EMOTION REGULATION PROFILES OF DEVELOP-MENT OF DEPRESSIVE SYMPTOMATOLOGY: A LON-GITUDINAL STUDY.
Teresa Paniagua, 1 Virginia Fernández-Fernández, 2 and MªÁngeles Molina Martínez, 3 , 1. Universidad Europea de MAdrid,Majadahonda,Madrid,Spain,2. Universidad Nacional de Educación a Distancia,Madrid,Madrid,Spain,3. Universidad Francisco de Vitoria,Madrid,Madrid,Spain Introduction: COVID-19 pandemic has had a psychological impact on the eldest population. The aim is to analyse whether there are differences depending on the emotional regulation profile shown by a group of older people 6 months before the pandemic and the depressive symptomatology of these people at the same time, during home confinement and 8 months later.
Conclusions: a "protected profile" (1), a "medium-term vulnerable profile" (2) and a "vulnerable profile" (3) to the development of depressive symptomatology. Suicide is a serious public health concern, particularly for individuals in later life. Studies suggest that greater attention to suicide prevention programs for older adults is needed as well as continued research related to interventions with older adults at risk of attempting suicide. A systematic review of the literature on suicide prevention treatment and effectiveness is fundamental to assessing existing services and developing new programs and practice standards. This systematic review of the literature extends an earlier and well-cited systematic review  by examining articles published between 2009 and 2021 with a focus on what types of empirically evaluated suicide prevention programs effectively prevent and reduce suicidality in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to gather the appropriate extant research and improve reporting accuracy. A three-stage review guided the selection of the articles. At stage one, titles were screened, which excluded 284 articles based on the inclusion criteria. Second, after a full review of each abstract, a final 14 articles remained for full-text review. Lastly, three independent researchers reviewed each of the full-text articles, and six articles were excluded. The final sample includes eight articles (N=8). The articles were categorized into three types of programs: 1) primary and home health care, 2) community-based outreach, and 3) counseling. Following a description of the articles, the authors assessed each study using the GRADE rating system. Findings underscore the critical need for evidence-based suicide prevention programs for older adults. Implications for future research are offered.

EXAMINING MEASUREMENT INVARIANCE OF DEPRESSION AMONG MALE AND FEMALE IN CHINESE OLDER ADULTS Roberto Melipillán, 1 and Mengyao Hu, 2 , 1. Universidad del Desarrollo, Concepcion, Bio-Bio, Chile, 2. University of Michigan, Ann Arbor, Michigan, United States
Depression of older adults is an important public health concern. With the increasing popularity of cross-cultural research and comparison studies, researchers are facing a difficult problem: responses to the depression scales obtained from different population groups may not always be comparable. This study examines the measurement invariance of the 10-item version of the Center for Epidemiological Studies Depression (CES-D) Scale across male and female in Chinese older adults. Data are drawn from the baseline wave of the China Health and Retirement Survey (CHARLS), a national survey conducted biennially with a sample of the Chinese population who are 45 years of age or older. The final sample size includes 15,977 respondents; 53.2% of whom are female. The mean age for the sample is 58.3 (SD = 10.2). Measurement invariance (MI) tests based on Multiple Group Categorical Confirmatory Factor Analyses (MGCCFA) was performed. Results show that full scalar model was not supported, and question items invariant across groups were identified. These results indicate that any mean comparisons of CES-D across Chinese male and female older adults not accounting for the noninvariance in the items could be biased, highlighting the importance of performing MI tests before conducting mean comparisons across groups.

HOW DO ALCOHOL USE AND DEPRESSION PREDICT GRIP STRENGTH AMONG MIDDLE-AGED AND OLDER ADULTS?
Song Ge, 1 Linda Dune, 2 Desiree' Frantz, 2 Laurel Laviolette, 2 Mary Njuguna, 3 xianping tang, 4 and Changwei Li, 5 , 1. University of Houston-Downtown, University of Texas,United States,2. University of Houston Downtown,Houston,Texas,United States,3. University of Houston downtown,Richmond,Texas,United States,4. Xuzhou Medical University,Xuzhou,Jiangsu,China (People's Republic),5. Tulane University School of Public Health and Tropical Medicine,New Orleans,Louisiana,United States Background: Physical performance is an important indicator that reflects current and predicts future health. In this study, we examined the association of alcohol use and depression with grip strength a national sample of middle aged and older Chinese adults.
Methods: We used the baseline data from the China Health and Retirement Longitudinal Study (CHARLS) and constructed a multivariate linear regression using SAS 9.4 to examine the independent association of alcohol use (never, former, moderate, and at-risk drinkers) and depression with grip strength controlling for socio-economic factors and domestic partner status.
Results: The study population consisted of 12,488 Chinese adults(mean age 59). The prevalence of ever drinking during lifetime and current at-risk drinking (>14 standard drinks [one standard drink contains 14 grams of pure alcohol] per week) in this population was 25.7% and 15.2% respectively. 28.4% of the study population had depression. Compared with never drinkers, moderate and at-risk alcohol use were independently associated with better grip strength (P<0.0001). Depression was independently negatively associated with grip strength (P<0.0001).
Conclusions: We found that current alcohol use might be protective of grip strength while depression might be detrimental to grip strength among middle-aged adults. However, the underlying mechanism is unclear. Given the negative impact of alcohol and depression on adults' overall health, clinicians should assess alcohol use and depression in middleaged and older patients using validated tools and provide resources. Clinicians should counsel patients that if depression is not managed, patients may suffer from depression associated health consequences such as declined grip strength.